Prostate Cancer – Common, Curable Disease
By Robert Pugach, MD
Hardly a week goes by without reading or hearing about someone you know, or some celebrity, learning that he has prostate cancer. There is a good reason for this. We now diagnose more than a quarter of a million new cases of prostate cancer every year. Fifty thousand (50,000) men die from prostate cancer every year. Prostate cancer is the second leading cause of death from cancer among US men. These are frightening statistics.
Patients, friends and family members are not statistics. This common cancer strikes at people we know far too often. Why? One reason is our increasing life expectancy – prostate cancer is a disease of getting older and most men now live long enough to develop it. At Western States HIFU and Western States HIFU my staff and I firmly believe in the value of early detection, using PSA testing and simple physical examination, because early detection is the key to successful treatment. (View Dr. Pugach’s prostate cancer educational videos.)
Learn the facts of Prostate Cancer Causes, Diagnosis and Treatments.
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Causes of Prostate Cancer
While the causes of prostate cancer are still unknown, some risk factors for the disease, such as advancing age and a family history of prostate cancer, have been identified. Prostate cancer is probably not related to benign prostatic hypertrophy (BPH).
Some of the risk factors for prostate cancer include:
- Age – the chances of developing prostate cancer increase with age
- Genetics (Black American men have a higher risk of getting prostate cancer than do Japanese or White American men)
- Heredity (a person whose father, or paternal grandfather or uncle has prostate cancer is at an increased risk for also developing prostate cancer)
- Hormonal influences (Testosterone, the male hormone, directly stimulates the growth of both normal prostate tissue and, perhaps, prostate cancer cells)
- Environmental, dietary and lifestyle factors; such as, smoking, diets high in saturated fats, toxins, chemicals, and industrial products.
- Obesity
Signs and Symptoms of Prostate Cancer
Most cases of prostate cancer do not produce any symptoms in its early stages so it can grow and spread silently beyond the prostate. That’s why annual screening with a brief examination and PSA blood test is so important – it can save your life.
When signs and symptoms begin, they may include some of the following:
- Blood in your urine
- Dull pain in your lower pelvic area
- General pain in your lower back, hips or upper thighs
- Urgency of urination
- Difficulty starting urination
- Pain during urination
- Loss of appetite and weight
- Painful ejaculation
- Persistent bone pain
- Weak urine flow and dribbling
- Intermittent urine flow
- A sensation that your bladder is not empty
- Frequent urination during the night
Can Prostate Cancer be Prevented?
To date, no specific prostate cancer gene has been identified and verified and no specific measures are known to prevent the development of prostate cancer. We can hope only to prevent the spread of the cancer by making early diagnoses and then attempting to cure the disease. Early detection of prostate cancer can be made by screening men by routine yearly digital rectal examinations beginning at age 45 and the addition of an annual PSA test. The purpose of the screening is to identify early, tiny, or microscopic cancers that are confined to the prostate gland. Early treatment of these cancer cells can stop the growth, prevent the spread, and, possibly, cure the cancer. In fact, most cases of prostate cancer can be cured when it is detected at an early stage.
Dietary measures have been suggested to prevent the growth of prostate cancer. Maintaining a diet low in saturated fats and avoiding red meats are recommended and believed to slow the down the growth rate of prostate tumors in a way not yet known. Soybean products work by decreasing the amount of testosterone circulating in the blood and may also inhibit the growth of prostate tumors. Many studies show that tomato products (lycopenes), the mineral selenium, and vitamin E might slow the growth of prostate tumors in ways that are not yet understood. Flaxseed oil may also be beneficial.
How is Prostate Cancer Diagnosed?
When prostate cancer is diagnosed on the biopsy tissue, the pathologist will then grade each of two pieces of the tissue from 1 to 5 on the Gleason scale. The scale is based on certain microscopic characteristics of the cancerous cells and reflects the aggressiveness of the tumor. The two scores are then added together. Sums of 2 to 4 are considered low, indicating a slowly growing tumor. Sums of 5 and 6 are intermediate, representing an intermediate degree of aggressiveness. Sums of 7 to 10 are considered high, signaling a rapidly growing tumor.
If you are a man over 45 years of age and/or have any of the aforementioned risk factors, Dr. Pugach recommends you schedule a digital rectal exam and a PSA blood test.
* Refinements in the PSA test, including the PSA ratio, age-specific PSA, PSA subtypes and PSA velocity or slope have improved the accuracy of the test.
How is Prostate Cancer Treated?
The choice of treatment for prostate cancer depends on the size, aggressiveness, and extent or spread of the tumor, as well as on the age, general health, preference of the patient and recommendation of your doctor.
There are many options for treating prostate cancer including surgery, cryoablation, brachytherapy, High Intensity Focused Ultrasound, hormonal treatment, chemotherapy, combinations of some of these treatments, and watchful waiting.
- Cryoablation: The concept behind cryoablation is to create an ice ball within the prostate to achieve sub-freezing temperature – typically in the – 40°C range – using Argon gas. When the “lethal ice” temperature is reached, cancer cells (which are more susceptible to cold temperatures than normal, healthy cells) are killed.
- Brachytherapy: The concept behind brachytherapy is to place tiny radioactive seeds, about ¼” long and the diameter of a pin, throughout the prostate in order to deliver a constant dose of radiation for several months to kill prostate cancer cells.
- High Intensity Focused Ultrasound: Dr. Pugach also is one of a few urologists in the United States trained and skilled in treating prostate cancer patients with High Intensity Focused Ultrasound (HIFU) HIFU uses ultrasound energy to heat and destroy targeted areas of tissue. The sound waves pass through healthy tissue without causing damage. HIFU is not yet approved for use in the United States but is available in many other countries.
It is important that you educate yourself well about prostate cancer. Screening and early diagnosis are key. Get the facts. Make an appointment with your urologist or primary care physician to schedule your prostate cancer screening.